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目的通过对2012-2014年神农架林区全人群住院患者疾病构成和疾病负担的分析,掌握湖北省神农架林区疾病流行趋势,为有效预防和控制疾病的发展提供科学依据。方法选取区内外医疗机构自2012-2014年的居民住院病例资料。以患者出院诊断结论为依据,按照《疾病和有关健康问题的国际统计分类(ICD-10)》的标准进行分类编码,以Excel 2007建立数据库,采用Epi Info.exe流行病学统计软件对全区全人群住院病例按照男女、年龄组的疾病系统分类、住院天数和住院费用等变量的筛选统计。统计学处理方法采用χ2检验。P<0.05为差异有统计学意义。结果 2012-2014年住院病例共23 447例,总住院率为98.35‰。女性占50.35%,男性占49.64%,女性略多于男性,男女住院人数差异无统计学意义(P>0.05)。65岁以上人群住院率最高,达到274.32‰。住院人次由2012年的6 180人次上升到2014年的8 975人次,增长了45.23%;住院费用12 500万元,住院费用由2012年的3 119万元上升到2014年的5 329万元,增长了70.86%。慢性病3年住院患者19 336人次,住院费9 672万元,分别占82.47%和77.38%,住院人次和费用均位居首位。住院患者疾病前10位依次为慢性阻塞性肺疾病(慢阻肺)、冠心病、宫颈炎、胃肠炎、肺炎、恶性肿瘤、脑梗死、高血压、胆结石和椎间盘突出。其中男性以慢阻肺居首位,女性以宫颈炎为首位。结论住院人次和医疗费用呈现逐年上升的趋势。慢阻肺、冠心病、脑梗死等慢性病仍然是危害全区居民健康的常见病和多发病,人口老龄化已经是慢性病住院率上升的主要影响因素。
Objective To analyze the disease composition and disease burden of inpatients in Shennongjia forest from 2012 to 2014 in order to grasp the epidemic trend of the disease in Shennongjia forest area of Hubei Province and provide a scientific basis for the effective prevention and control of disease development. Methods The data of resident inpatients from 2012 to 2014 in medical institutions in and outside China were selected. Based on the diagnosis of patients discharged, according to the “International Statistical Classification of Diseases and Related Health Problems (ICD-10)” standard classification codes to create a database Excel 2007, the use of Epi Info.exe epidemiological software for the entire region The entire population of inpatient cases were screened according to the classification of the disease system of men and women, age groups, days of hospitalization and hospitalization costs. Statistical analysis using χ2 test. P <0.05 for the difference was statistically significant. Results A total of 23,447 hospitalizations were carried out in 2012-2014, with a total hospitalization rate of 98.35%. Women accounted for 50.35%, men 49.64%, women slightly more than men, there was no significant difference in the number of men and women in hospital (P> 0.05). The rate of hospitalization was highest in people over 65 years old, reaching 274.32 ‰. The number of inpatient visits increased from 6 180 in 2012 to 8 975 in 2014, an increase of 45.23%. The hospitalization expenses were 125 million and the cost of hospitalization increased from 31.19 million in 2012 to 53.39 million in 2014, An increase of 70.86%. 19 336 inpatients with chronic diseases and 96.72 million inpatients were hospitalized for chronic diseases, accounting for 82.47% and 77.38% respectively, with the highest number of inpatients and expenses. The top 10 inpatient diseases were chronic obstructive pulmonary disease (COPD), coronary heart disease, cervicitis, gastroenteritis, pneumonia, malignant tumor, cerebral infarction, hypertension, gallstones and disc herniation. Among them, men take the first place with COPD, while women with cervicitis rank the first place. Conclusion Inpatient visits and medical expenses show an upward trend year by year. Chronic obstructive pulmonary disease, coronary heart disease, cerebral infarction and other chronic diseases are still the common and frequently-occurring diseases that endanger the health of residents in the whole region. The population aging has become the main factor for the increase of hospitalization rate of chronic diseases.